Mortality related to Verona Integron-encoded Metallo-β-lactamase-positive Pseudomonas aeruginosa: assessment by a novel clinical tool
Abstract Background Verona Integron-encoded Metallo-β-lactamase-positive Pseudomonas aeruginosa (VIM-PA) can cause nosocomial infections and may be responsible for increased mortality. Multidrug resistance in VIM-PA complicates treatment. We aimed to assess the contribution of VIM-PA to mortality in...
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| Format: | Article |
| Language: | English |
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BMC
2019-06-01
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| Series: | Antimicrobial Resistance and Infection Control |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s13756-019-0556-9 |
| _version_ | 1818306500341268480 |
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| author | Marjolein C. Persoon Anne F. Voor in ‘t holt Maurits P. A. van Meer Karen C. Bokhoven Diederik Gommers Margreet C. Vos Juliëtte A. Severin |
| author_facet | Marjolein C. Persoon Anne F. Voor in ‘t holt Maurits P. A. van Meer Karen C. Bokhoven Diederik Gommers Margreet C. Vos Juliëtte A. Severin |
| author_sort | Marjolein C. Persoon |
| collection | DOAJ |
| description | Abstract Background Verona Integron-encoded Metallo-β-lactamase-positive Pseudomonas aeruginosa (VIM-PA) can cause nosocomial infections and may be responsible for increased mortality. Multidrug resistance in VIM-PA complicates treatment. We aimed to assess the contribution of VIM-PA to mortality in patients in a large tertiary care hospital in the Netherlands. Methods A focus group of five members created a scheme to define related mortality based on clinical and diagnostic findings. Contribution to mortality was categorized as “definitely”, “probably”, “possibly”, or “not” related to infection with VIM-PA, or as “unknown”. Patients were included when infected with or carrier of VIM-PA between January 2008 and January 2016. Patient-related data and specific data on VIM-PA cultures were retrieved from the electronic laboratory information system. For patients who died in our hospital, medical records were independently reviewed and thereafter discussed by three physicians. Results A total of 198 patients with any positive culture with VIM-PA were identified, of whom 95 (48.0%) died. Sixty-seven patients died in our hospital and could be included in the analysis. The death of 15 patients (22.4%) was judged by all reviewers to be definitely related to infection with VIM-PA. In 17 additional patients (25.4%), death was probably or possibly related to an infection with VIM-PA. The level of agreement was 65.7% after the first evaluation, and 98.5% after one session of discussion. Conclusion Using our assessment tool, infections with VIM-PA were shown to have an important influence on mortality in our complex and severely ill patients. The tool may be used for other (resistant) bacteria as well but this needs further exploration. |
| first_indexed | 2024-12-13T06:43:28Z |
| format | Article |
| id | doaj.art-4b984ced2567426498c2b14452139dfd |
| institution | Directory Open Access Journal |
| issn | 2047-2994 |
| language | English |
| last_indexed | 2024-12-13T06:43:28Z |
| publishDate | 2019-06-01 |
| publisher | BMC |
| record_format | Article |
| series | Antimicrobial Resistance and Infection Control |
| spelling | doaj.art-4b984ced2567426498c2b14452139dfd2022-12-21T23:56:21ZengBMCAntimicrobial Resistance and Infection Control2047-29942019-06-01811810.1186/s13756-019-0556-9Mortality related to Verona Integron-encoded Metallo-β-lactamase-positive Pseudomonas aeruginosa: assessment by a novel clinical toolMarjolein C. Persoon0Anne F. Voor in ‘t holt1Maurits P. A. van Meer2Karen C. Bokhoven3Diederik Gommers4Margreet C. Vos5Juliëtte A. Severin6Department of Medical Microbiology and Infectious Diseases, Erasmus MC University Medical Center RotterdamDepartment of Medical Microbiology and Infectious Diseases, Erasmus MC University Medical Center RotterdamDepartment of Medical Microbiology and Infectious Diseases, Erasmus MC University Medical Center RotterdamDepartment of Adult Intensive Care, Erasmus MC University Medical Center RotterdamDepartment of Adult Intensive Care, Erasmus MC University Medical Center RotterdamDepartment of Medical Microbiology and Infectious Diseases, Erasmus MC University Medical Center RotterdamDepartment of Medical Microbiology and Infectious Diseases, Erasmus MC University Medical Center RotterdamAbstract Background Verona Integron-encoded Metallo-β-lactamase-positive Pseudomonas aeruginosa (VIM-PA) can cause nosocomial infections and may be responsible for increased mortality. Multidrug resistance in VIM-PA complicates treatment. We aimed to assess the contribution of VIM-PA to mortality in patients in a large tertiary care hospital in the Netherlands. Methods A focus group of five members created a scheme to define related mortality based on clinical and diagnostic findings. Contribution to mortality was categorized as “definitely”, “probably”, “possibly”, or “not” related to infection with VIM-PA, or as “unknown”. Patients were included when infected with or carrier of VIM-PA between January 2008 and January 2016. Patient-related data and specific data on VIM-PA cultures were retrieved from the electronic laboratory information system. For patients who died in our hospital, medical records were independently reviewed and thereafter discussed by three physicians. Results A total of 198 patients with any positive culture with VIM-PA were identified, of whom 95 (48.0%) died. Sixty-seven patients died in our hospital and could be included in the analysis. The death of 15 patients (22.4%) was judged by all reviewers to be definitely related to infection with VIM-PA. In 17 additional patients (25.4%), death was probably or possibly related to an infection with VIM-PA. The level of agreement was 65.7% after the first evaluation, and 98.5% after one session of discussion. Conclusion Using our assessment tool, infections with VIM-PA were shown to have an important influence on mortality in our complex and severely ill patients. The tool may be used for other (resistant) bacteria as well but this needs further exploration.http://link.springer.com/article/10.1186/s13756-019-0556-9Pseudomonas aeruginosaMortalityCarbapenemMicrobial drug resistanceInfection controlIntensive care units |
| spellingShingle | Marjolein C. Persoon Anne F. Voor in ‘t holt Maurits P. A. van Meer Karen C. Bokhoven Diederik Gommers Margreet C. Vos Juliëtte A. Severin Mortality related to Verona Integron-encoded Metallo-β-lactamase-positive Pseudomonas aeruginosa: assessment by a novel clinical tool Antimicrobial Resistance and Infection Control Pseudomonas aeruginosa Mortality Carbapenem Microbial drug resistance Infection control Intensive care units |
| title | Mortality related to Verona Integron-encoded Metallo-β-lactamase-positive Pseudomonas aeruginosa: assessment by a novel clinical tool |
| title_full | Mortality related to Verona Integron-encoded Metallo-β-lactamase-positive Pseudomonas aeruginosa: assessment by a novel clinical tool |
| title_fullStr | Mortality related to Verona Integron-encoded Metallo-β-lactamase-positive Pseudomonas aeruginosa: assessment by a novel clinical tool |
| title_full_unstemmed | Mortality related to Verona Integron-encoded Metallo-β-lactamase-positive Pseudomonas aeruginosa: assessment by a novel clinical tool |
| title_short | Mortality related to Verona Integron-encoded Metallo-β-lactamase-positive Pseudomonas aeruginosa: assessment by a novel clinical tool |
| title_sort | mortality related to verona integron encoded metallo β lactamase positive pseudomonas aeruginosa assessment by a novel clinical tool |
| topic | Pseudomonas aeruginosa Mortality Carbapenem Microbial drug resistance Infection control Intensive care units |
| url | http://link.springer.com/article/10.1186/s13756-019-0556-9 |
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